Emergency Medical Minute

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**Emergency Medical Minute**

Our near daily podcasts move quickly to reflect current events, are inspired by real patient care, and speak to the true nature of what it’s like to work in the Emergency Room or Pre-Hospital Setting. Each medical minute is recorded in a real emergency department, by the emergency physician or clinical pharmacist on duty – the ER is our studio and everything is live.

Latest Episodes:

Podcast #226: Biphasic Anaphylaxis Jul 18, 2017

Show notes

Author: Sam Killian, M.D.

Educational Pearls

Anaphylaxis is common in the ED. These patients are treated and then usually watched for 4-6 hours.
Biphasic happens in patients that have a complete resolution of their anaphylaxis for at least an hour, but then have a recurrence that requires pharmacologic intervention. Most of the time this happens 3-6 hours later, but can happen more than 10 hours later.
More commonly happens in patients that have a delayed presentation, a wide pulse pressure, need multiple doses of epi, require the use of a beta agonist, or are ages 6-9 years old.
Educate patients about the possibility of Biphasic anaphylaxis before discharge.

References: http://www.medscape.org/viewarticle/583328_7

Podcast #225: Rhogam Jul 16, 2017

Show notes

Author: Dylan Luyten, M.D.

Educational Pearls

Rhogam is commonly used when an Rh negative woman has an Rh positive fetus. It is commonly used in the ER in the setting of a miscarriage.
Rh(+) fetal blood can enter the Rh(-) maternal circulation, sensitizing the woman to the Rh antigen. During a subsequent pregnancy, if the fetus is Rh(+), the woman may mount an immune response to the fetus, lead to fetal demise. Rhogam is used to block this process.
Use of Rhogam has reduced this complication from 16% of Rh(+) pregnancies in the 1960's to less than 1% today.
Under 10 weeks, the amount of maternal-fetal blood exchange is very small, so the use of Rhogam in a 1st trimester miscarriage is unnecessary. It should be used in patients with a miscarriage after 12 weeks, or women undergoing a surgical D&C.
Rhogam is expensive and in limited supply, so it is important to only use it when necessary.

References: Hannafin, Blaine et al. Do Rh-negative women with first trimester spontaneous abortions need Rh immune globulin? 2006. The American Journal of Emergency Medicine, Volume 24 , Issue 4 , 487 - 489

Deep Dive #4: Pediatric Type I DKA Jul 14, 2017

Show notes

Author: Justin Harper

Justin Harper, a paramedic married to a pediatric nurse, discovered his own son had type I diabetes 2 years ago. Despite their medical experience, this diagnosis came as surprise to Justin and his wife. This is the compelling story about how their son was diagnosed with type I diabetes and how this has impacted their lives.

Brewcast Part VIII: Cannabis in Colorado Jul 09, 2017

Show notes

Author: Dr. Larry Wolk, Executive Director and Chief Medical Officer for the Colorado Department of Public Health and Environment.

Topic: Dr. Larry Wolk educates us on how cannabis has affected Colorado since medical and recreational legalization.

Brewcast Part VII: A Patient's Perspective on Medical Marijuana Jul 08, 2017

Show notes

Authors: Don Stader, M.D. & Lauren Gibbs

Topic: Lauren breaks the stoner stereotype and explains how marijuana has positively impacted her life.

Brewcast Part VI: Synthetic Marijuana Jul 07, 2017

Show notes

Author: Erik Verzemnieks, M.D.

Topic: Erik speaks about how slightly altering the chemical composition of marijuana can create a drug with drastic effects on the human body.

WARNING: Explicit Language

Brewcast Part V: Researching Cannabis Jul 06, 2017

Show notes

Author: Sophie Yorkwilliams

-B.A. (Psychology)

-Dual Ph.D. Candidate, Clinical Psychology and Neuroscience. Expected graduation: 2020

Topic: Studying cannabis comes with its own set of challenges. Find out how Sophie and her team have overcome obstacles to get accurate data on marijuana.

Brewcast Part IV: A Physician's Perspective on Medical Marijuana Jul 05, 2017

Show notes

Authors: Don Stader, M.D. & Peter Pryor, M.D.

Topic: What caused Dr. Pryor to leave emergency medicine and enter the realm of medical marijuana?

Brewcast Part III: Cannabinoid Hyperemesis Syndrome Jul 04, 2017

Show notes

Author: Rachael Duncan, PharmD BCPS BCCCP

Topic: Rachel explains the science behind one of the most common maladies thought to be induced by chronic cannabis use.

Brewcast Part II: Pharmacology of Cannabis Jul 03, 2017

Show notes

Author: Brett Marlin, M.D.

Topics: Brett explains the biochemical and physiological properties of cannabis.

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